How do empowerment and self-determination affect national health outcomes?

Abstract

There remains a persistent gap in health outcomes between wealthy and poor countries. Basic measures such as life expectancy, infant and child mortality remain divergent, with preventable deaths being unacceptably high, despite significant efforts to reduce these disparities. We examine the impact of empowerment, measured by Freedom House’s ratings of country’s political and civil rights freedom, while controlling for per capita GDP, secondary school enrollment and income inequality, on national health outcomes. Using data from 1970-2013 across 149 countries, our results suggest, quite strongly, that higher levels of empowerment have a significant positive association with life expectancy, particularly for females, and lower rates of infant and child mortality. Our results point to the need for efforts to stimulate economic growth be accompanied with reforms to increase the levels of empowerment through increased political and economic freedom.